Unresolved Neurological Symptoms: Seeking Answers After Multiple Hospital Visits

Q: Unresolved Neurological Symptoms: Seeking Answers After Multiple Hospital Visits

Hello： You mentioned that "seeking treatment at various hospitals and clinics has been ineffective" because your symptoms are atypical. <br>It may be necessary to first consider cervical myofascial inflammation and electrolyte issues. <br>The recommended principle for seeking med

Consulting various hospitals and clinics has been ineffective?

In recent months, I have been feeling unwell and have visited multiple hospitals seeking medical attention, but the answers I received were inconclusive.
X-rays showed no issues, and my heart and lungs were in good condition.
Here are my symptoms: about six months ago, I started experiencing intermittent headaches, which gradually progressed to olfactory hallucinations where I would smell burnt odors, along with tinnitus.
I didn't pay much attention to these symptoms at first.
Later, I began to experience pain on one side of my neck and at the occipital area, but it would improve after a few days.
These symptoms have been fluctuating but did not significantly affect my daily life.

However, last month, I started experiencing frequent numbness in my hands and feet, along with unexplained pulsations in my chest and various other areas, which made me anxious.
When I went to the emergency room, they told me everything was fine.
This month, I, who have been suffering from chronic constipation, had a week of diarrhea, but after undergoing a stool routine and another X-ray, everything appeared normal.

Yesterday, due to fatigue, I took a two-hour nap in the afternoon.
Upon waking, I suddenly felt pain in the left upper back, around the T3 to T5 region, along with slight chest discomfort.
I first visited a clinic where the doctor assessed that there was not much to worry about.
They measured my blood pressure in both arms, which showed little difference, with a 10 mmHg difference in systolic pressure, leading them to believe it was not a cardiovascular issue.
They diagnosed me with a muscle strain, which left me confused since I do not have a regular exercise routine and certainly do not engage in weight training.
Today, I went to another hospital's emergency department for further evaluation.
The X-ray and blood tests also showed no issues, but now the pain has spread to the left side of my neck, temple, and head, where I feel a throbbing pain.
I have taken pain medication, but it has been completely ineffective.
What should I do? What do you think might be the underlying condition, and in which direction should I seek further medical evaluation?

Mr. Lin, 20~29 year old female. Ask Date: 2022/07/15

Dr. Jiang Junyi reply Neurology

Hello: You mentioned that "seeking treatment at various hospitals and clinics has been ineffective" because your symptoms are atypical.
It may be necessary to first consider cervical myofascial inflammation and electrolyte issues.
The recommended principle for seeking medical care is to find a nearby hospital with an emergency department to consolidate your medical information in one place.
Due to the principles of health insurance review, when general examinations do not provide further information, advanced testing can be conducted.
Please ensure self-protection and maintain cleanliness and disinfection before and after your medical visits.
To implement the new preventive measures, it is advisable to visit a neurology outpatient clinic for examination and follow-up.
Wishing you good health and peace of mind.
Dr.
Jiang Junyi from Taoyuan Medical Center cares about you.

Reply Date: 2022/07/15

More Info

It sounds like you have been experiencing a complex array of neurological symptoms that have persisted for several months, leading to significant distress and uncertainty regarding your health. Your symptoms, including intermittent headaches, olfactory hallucinations (smelling burnt odors), tinnitus (ear ringing), unilateral neck pain, and recent episodes of numbness in your extremities, are indeed concerning and warrant thorough investigation.

Given the multifaceted nature of your symptoms, it is essential to approach this situation systematically. Here are some potential avenues to explore:
1. Neurological Evaluation: Since your symptoms are neurological in nature, a consultation with a neurologist is crucial. They can perform a comprehensive neurological examination, which may include assessing your reflexes, muscle strength, coordination, and sensory responses. This evaluation can help identify any neurological deficits that may not be apparent through standard imaging or blood tests.

2. Advanced Imaging: While X-rays and routine blood tests have not revealed any abnormalities, further imaging studies such as an MRI of the brain and cervical spine may be necessary. An MRI can provide detailed images of the brain and spinal cord, helping to identify any lesions, inflammation, or structural abnormalities that could explain your symptoms. Given your olfactory hallucinations and other neurological signs, it is vital to rule out conditions such as multiple sclerosis, tumors, or other central nervous system disorders.

3. Electrophysiological Studies: Tests such as electromyography (EMG) and nerve conduction studies (NCS) can assess the electrical activity of your muscles and the integrity of your peripheral nerves. These tests can help identify conditions like peripheral neuropathy or radiculopathy, which could explain your numbness and pain.

4. Consider Systemic Conditions: Some systemic conditions can manifest with neurological symptoms. Conditions such as autoimmune disorders (e.g., lupus, Sjögren's syndrome), vitamin deficiencies (e.g., B12 deficiency), or thyroid dysfunction can lead to neurological symptoms. A thorough review of your medical history, along with targeted blood tests, may be warranted to rule out these possibilities.

5. Pain Management: Since you are experiencing significant pain, it may be beneficial to consult a pain management specialist. They can provide strategies to manage your pain effectively, which may include medications, physical therapy, or other interventions.

6. Psychological Support: Chronic pain and unresolved medical issues can lead to anxiety and depression. It may be helpful to seek support from a mental health professional who can assist you in coping with the emotional aspects of your condition.

7. Follow-Up and Persistence: It is essential to maintain open communication with your healthcare providers. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion. Persistence is key in navigating complex medical issues.

In summary, your symptoms are multifactorial and require a thorough and multidisciplinary approach to diagnosis and management. Engaging with a neurologist for further evaluation, considering advanced imaging and electrophysiological studies, and exploring potential systemic conditions are critical steps. Additionally, addressing pain management and psychological support can significantly enhance your quality of life as you navigate this challenging situation. Remember, you are your best advocate, and seeking clarity and answers is essential for your health and well-being.

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